The high-sensitivity C-reactive protein to lymphocyte ratio is associated with all-cause and cardiovascular mortality in U.S. adults: A cohort study from NHANES 2015 to 2018

Despite concerted global efforts, cardiovascular disease persists as the foremost cause of mortality globally and a significant impediment to the advancement of public health and human development. This study leveraged National Health and Nutrition Examination Survey data to assess the relationship between high-sensitivity C-reactive protein to lymphocyte ratio (hsCLR) and all-cause as well as cardiovascular mortality.in general U.S. adults. We conducted a cohort study involving 10,335 adult participants aged 18 years and older from the National Health and Nutrition Examination Survey database. Multivariable Cox regression models were employed to assess hsCLR and its tertiles in relation to mortality risk. Kaplan-Meier survival curves, subgroup analyses, and sensitivity tests were performed to confirm the stability of the results, alongside restricted cubic spline analyses to evaluate the linearity of the association. After adjusting for covariates, hsCLR emerged as an independent predictor of both all-cause mortality (hazard ratio = 1.32, 95% CI: 1.21-1.44, P < .001) and cardiovascular mortality (hazard ratio = 1.45, 95% CI: 1.23-1.71, P < .001). Participants with higher hsCLR levels exhibited significantly lower survival rates (P < .001). Restricted cubic spline analysis confirmed a positive linear association between hsCLR and mortality risk. Increased hsCLR is a powerful, independent predictor of death and might function as a clinically relevant biomarker for risk assessment in the general U.S. populace. These findings highlight the potential utility of hsCLR in identifying individuals at higher mortality risk.